Organization Active NPI

Unity Mental Health Wellness LLC

  • Clinical Social Worker
  • Green Bay, WI
National Provider Identifier
1568310399
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
UNITY MENTAL HEALTH WELLNESS LLC
Practice address
2563 Development Dr
Green Bay, WI 54311-4246
Phone
(920) 600-9949
NPI assigned
Mar 18, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Pakou ThaoNPI 1073241816
Title
Clinical Therapist
Phone
(920) 600-9949

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2563 Development Dr
Green Bay, WI 54311-4246

Mailing address

1041 Main Ave # 665
De Pere, WI 54115-1307
Phone (414) 465-9708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260604004474 WI Part B Supplier - Clinic/Group Practice 7810468386 Receives reassigned benefits from 1 practitioner
Practice locations: De Pere, WI

National Provider Directory

National Provider Directory

Locations

1041 Main Ave
De Pere, WI 54115

2563 Development Dr
Green Bay, WI 54311
Phone (920) 207-1927

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784678400000",
    "number": "1568310399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 MAIN AVE # 665",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541151307",
            "telephone_number": "414-465-9708",
            "fax_number": "414-465-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2563 DEVELOPMENT DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114246",
            "telephone_number": "920-600-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITY MENTAL HEALTH WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-18",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A",
        "authorized_official_last_name": "THAO",
        "authorized_official_first_name": "PAKOU",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "920-600-9949"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.